Multiple sclerosis : a protein announces the relapse and adjust the treatment

According to a study published in the journal Neurology, the presence of a protein in the blood of patients with a relapsing-remitting form of multiple sclerosis, the protein NF-L, could announce relapse, and allow to better adjust the treatment to the level of activity of the disease.

85 patients followed for two years

A study published by the American Academy of Neurology shows that the presence of protein, neurofilament light chain (NF-L), and chitinase-3 like protein 1 (CHI3L1), can help predict outbreaks of the disease, in the context of a relapsing-remitting form of multiple sclerosis. The researchers followed 85 patients with multiple sclerosis relapsing-remitting, and this for two years. During the first six months, these patients were not taking treatment. Then, for a year and a half, they were treated with interferon beta-1a, an immunomodulatory treatment effective in SEP. Blood samples were collected at baseline, and then at the end of the third, sixth, twelfth and twenty-fourth months. The researchers then studied the rate of neurofilament light chain (NF-L) in the blood.

A high rate of NF-L sign a thrust

According to the results of the study, the patients who have a high rate of NF-L in blood, in parallel, of new brain lesions visible on MRI (T1-gado and T2), which is not the case in patients whose rate remains low. The rate of NF-L decreased during treatment with interferon beta-1a and, therefore, gives witness to a new surge in multiple sclerosis and its treatment. At the same time, in this study the rate of CHI3L1 is not correlated to the MRI lesion, or the treatment and does not seem to really reflect the inflammatory disease of the nervous system.

An inflammatory disease

There are two types of multiple sclerosis. The most widespread at the beginning of the disease is multiple sclerosis in its relapsing-remitting form. That is to say, it evolves by alternating phases of flares and phases of remission. Patients can live with the unique form of the disease. But, from the outset, in some patients, or secondarily for others, appears to be a progressive form. Patients with progressive ms do not have more thrust. But disability gradually settles. It may worsen slowly or very quickly.

As well, monitor the rate of NF-L in the blood of patients could help to prevent flare-ups of multiple sclerosis. The researchers are seeing in NF-L as a biomarker promising of the activity of the disease, useful to adjust the treatment to the more close to the needs of the disease. NF-L could also become an alternative to MRI, one of the imaging techniques to be the most expensive and to which access remains limited in France.